Jia Yi Anna Ne1, Vincent Chow2, Leonard Kritharides3, Austin Chin Chwan Ng4. 1. Greenslopes Private Hospital, QLD, Australia; Cardiology Department, Concord Hospital, Hospital Road, Concord 2139, NSW, Australia. Electronic address: jine4225@uni.sydney.edu.au. 2. Cardiology Department, Concord Hospital, The University of Sydney, Hospital Road, Concord 2139, NSW, Australia. Electronic address: vincent.chow@sydney.edu.au. 3. Cardiology Department, Concord Hospital, The University of Sydney, Hospital Road, Concord 2139, NSW, Australia. Electronic address: leonard.kritharides@sydney.edu.au. 4. Cardiology Department, Concord Hospital, The University of Sydney, Hospital Road, Concord 2139, NSW, Australia. Electronic address: chin.ng@sydney.edu.au.
Abstract
BACKGROUND: Congestive heart failure (CHF) is a risk factor for pulmonary embolism (PE). PE is also an independent predictor of death or re-hospitalization among CHF patients. We assessed the incidence of CHF admission following acute PE using population-linkage analysis. METHODS: Patients were identified from a comprehensive single-center PE database and CHF admissions or death after their PE were tracked from the statewide Admitted Patient Data Collection and Death registries respectively. Patients were divided into two groups: Group-1 were patients without a history of CHF and left ventricular ejection fraction (LVEF) ≥50%; Group-2 were patients with a history of CHF and/or LVEF <50%. Cox regression was used to identify independent predictors for post-PE CHF admission or death. RESULTS: The study cohort comprised 515 patients (Group-1: n = 338 [65.6%]; Group-2: n = 177 [34.4%]). The incidence of first CHF hospitalization after discharge for acute PE over a mean (±SD) follow-up period of 4.7 ± 3.7 years for the total cohort was 71 (13.8%), with the rate significantly higher in Group-2 than Group-1 (Group-2: [n = 58] 9.11 per-100-patient-years vs Group-1: [n = 13] 0.73 per-100-patient-years). Independent predictors for CHF admission or death after acute PE were older age, male gender, history of CHF or malignancy, low day-1 serum hemoglobin, on diuretics during index PE admission, LVEF <50%, and elevated right ventricular-atrial pressure gradient on echocardiography. CONCLUSION: We report a high incidence of CHF requiring hospital admission after acute PE. Surveillance for new-onset heart failure and close monitoring for heart failure decompensation following acute PE particularly in at-risk groups may be warranted.
BACKGROUND:Congestive heart failure (CHF) is a risk factor for pulmonary embolism (PE). PE is also an independent predictor of death or re-hospitalization among CHFpatients. We assessed the incidence of CHF admission following acute PE using population-linkage analysis. METHODS:Patients were identified from a comprehensive single-center PE database and CHF admissions or death after their PE were tracked from the statewide Admitted Patient Data Collection and Death registries respectively. Patients were divided into two groups: Group-1 were patients without a history of CHF and left ventricular ejection fraction (LVEF) ≥50%; Group-2 were patients with a history of CHF and/or LVEF <50%. Cox regression was used to identify independent predictors for post-PE CHF admission or death. RESULTS: The study cohort comprised 515 patients (Group-1: n = 338 [65.6%]; Group-2: n = 177 [34.4%]). The incidence of first CHF hospitalization after discharge for acute PE over a mean (±SD) follow-up period of 4.7 ± 3.7 years for the total cohort was 71 (13.8%), with the rate significantly higher in Group-2 than Group-1 (Group-2: [n = 58] 9.11 per-100-patient-years vs Group-1: [n = 13] 0.73 per-100-patient-years). Independent predictors for CHF admission or death after acute PE were older age, male gender, history of CHF or malignancy, low day-1 serum hemoglobin, on diuretics during index PE admission, LVEF <50%, and elevated right ventricular-atrial pressure gradient on echocardiography. CONCLUSION: We report a high incidence of CHF requiring hospital admission after acute PE. Surveillance for new-onset heart failure and close monitoring for heart failure decompensation following acute PE particularly in at-risk groups may be warranted.
Authors: Juan A Quintero-Martinez; Waldemar E Wysokinski; Sandra N Cordova-Madera; Renzo J Mogollon; Mariana Garcia-Arango; Danielle T Vlazny; Damon E Houghton; Ana I Casanegra; Hector R Villarraga Journal: Eur Heart J Open Date: 2022-02-23